Adolescent transitions to adult health care mark a pivotal point in adolescent development and health. Adult health care requires patients to make independent health care decisions. The health habits and skills needed to make those decisions are established during adolescence, and shape medical care and overall health throughout life. Low health literacy (HL) is a significant barrier to medical care and to achieving optimal health. Health literacy has been studied extensively among adults, but not among adolescents. This K-01 award supports Dr. Laura Shone in a focused plan of mentored research and training to investigate the measurement and role of health literacy in adolescents' and young adults' transitions to adult health care. This project provides Dr. Shone with a rigorous didactic and experiential mentored research and training development experience that will successfully establish her as an independent investigator in health services and public health research. Dr. Shone's didactic curriculum includes 9 courses, and 3 intensive methods institutes. She will conduct a mentored research project involving 4 Aims: 1) Determining which methods are most suitable for measuring health literacy in middle-and late-adolescents in clinical, research, and public health surveillance and intervention settings; 2) Identifying associations between adolescent health literacy and defined aspects of the health care process and outcomes among adolescents; 3) Assessing adolescents' knowledge, attitudes, beliefs, and preferences about resources and intervention strategies to improve the processes and outcomes of adolescent health care; and 4) Developing and assessing the feasibility of intervention strategies based on data from aims 1-3, above, tailored to adolescents' developmental, clinical, and self-identified needs. This new knowledge will improve the delivery of adolescent health care and preventive health behavior among youth, and will help prepare adolescents for the transition to self-management of chronic conditions and overall health care as young adults. These studies will help shape community health interventions to meet public health needs for individuals at all levels of health literacy. Relevance to public health: It is important to identify low HL among transition-age youth to design and implement services that can facilitate the transition from pediatric to adult care, to improve health literacy and also improve the processes and outcomes of health care among adolescents and young adults. [unreadable] [unreadable] [unreadable]